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Aim – to find regular patterns in the morphometric characteristics for the bodies of the cervical vertebrae when performing measurements in the axial (transverse) plane in men and women with different severity of degenerative-dystrophic changes of the cervical spine. Material and methods. The material of the study was the tomograms of 75 men and 128 women aged 18 to 84 years, obtained on magnetic resonance tomographs with a magnetic field strength of 1 Tl and 1.5 Tl. The data was divided into several groups according to the patients' sex and severity of degenerative-dystrophic changes of the cervical spine. The length and width of the vertebral bodies in the axial plane were measured with the subsequent calculation of their ratio. Results. Significant differences were found between the 1st and 2nd groups for the width of C7-C4 in women, as well as for the length of C3 and width of C3, C2 in men. Significant difference in the ratio of the sizes of vertebral bodies was registered in the 1st and 2nd groups of women at the level of C7. When comparing the data of all observation groups among men, significant differences were noted in the 2nd and 3rd groups for C7, C6, C3. With progression of degenerative-dystrophic changes, the differences in length were significant for C7-C4, C2 vertebrae in the 1st group, for C7-C5, C2 – in the 2nd and C7, C6, C4-C2 in the 3rd group. In the group of men with pronounced changes in the cervical spine region, in most cases there was an increase in coefficients (with significant differences in data for the 2nd and 3rd groups). Conclusion. Among men, significant differences were observed between the 2nd and 3rd groups for C7, C6, C3. For the C2 vertebra, significant differences were noted, taking into account sex, for length in the 1st and 3rd groups, width – in the 1st and 2nd groups, when assessing the mutual ratio of the sizes of the vertebral bodies – in the 2nd and 3rd groups.

Background: The aim of this study is to search for the predictive value of 3D fat analysis and calculation technique (FACT) and intravoxel incoherent motion (IVIM) parameters in identifying osteoporosis in women. Methods: We enrolled 48 female subjects who underwent 3.0 T MRI, including 3D FACT and IVIM sequences. Bone mineral density (BMD) values and Fracture Risk Assessment (FRAX) scores were obtained. Proton density fat fraction (PDFF) in the bone marrow and the real diffusion (D) value of intervertebral discs were measured on 3D FACT and IVIM images, respectively. Accuracy and bias were assessed by linear regression analysis and Bland–Altman plots. Intraclass correlation coefficients were used to assess the measurements' reproducibility. Spearman's rank correlation was applied to explore the correlation. MRI-based parameters were tested for significant differences among the three groups using ANOVA analyses. A receiver operating characteristic (ROC) analysis was performed. Results: The PDFF of the vertebral body showed a negative correlation with BMD (R = −0.393, p = 0.005) and a positive correlation with the FRAX score (R = 0.706, p < 0.001). The D value of intervertebral discs showed a positive correlation with BMD (R = 0.321, p = 0.024) and a negative correlation with the FRAX score (R = −0.334, p = 0.019). The area under the curve values from the ROC analysis showed that the 3D FACT and IVIM sequences could accurately differentiate between normal and osteoporosis (AUC = 0.88 using the PDFF; AUC = 0.77 using the D value). The PDFF value demonstrated a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 78.6%, 89.5%, 84.6%, and 85.0%, respectively, in its ability to predict osteoporosis. The D value had a sensitivity, specificity, PPV, and NPV of 63.16%, 92.9%, 65.0%, and 77.8%, respectively, for predicting osteoporosis. Conclusions: The 3D FACT- and IVIM-measured PDFF and D values are promising biomarkers in the assessment of bone quality and fracture risk. [ABSTRACT FROM AUTHOR]

Introduction The more accurate is the measurement of the parameters for correcting the deformity of damaged spinal segments the more accurate will be the restoration of the sagittal profile and original anatomy of the spine. Purpose Substantiation of calculated indicators for deformity correction in one or two damaged spinal motion segments in the thoracic and lumbar spine according to spiral computed tomography. Material and methods The material for the study was the results of spiral computed tomography (SCT) of an anatomically unchanged thoracic and lumbar spine in 25 patients (12 women and 13 men aged 18 to 60 years). The study model consisted of three vertebral bodies and four adjacent discs from T4 to L4. Anterior and posterior dimensions of the vertebral bodies, intervertebral discs, and segmental deformity angle α (formed by the lower endplate of the overlying vertebra and the upper endplate of the underlying vertebra) were measured using RadiAnt computer software in the midsagittal projection. Damage to the body of the middle vertebra with adjacent discs was modeled, the dimensions of which were calculated from the adjacent vertebral bodies and adjacent discs. Statistical processing of the material was carried out using the computer software SPSS Statistics. Results The measurement error of the anterior interbody spaces was 1.4 ± 0.4 mm, the posterior interbody spaces were 1.3 ± 0.5 mm, the error in calculating the segmental deformation angle α was 2.5 ± 0.6 degrees, what indicates the high accuracy of the proposed method. Discussion The use of absolute deformity values as a standard for surgical intervention in the treatment of vertebral fractures is complicated by varieties of normal anatomy. Conclusion The proposed calculations for the restoration of the anterior and posterior interbody distances, as well as the angle of segmental deformity α after a spinal cord injury of the thoracic and lumbar spine provide an approach to the target individualized anatomical dimensions.

We determined the height of the lumbar vertebral bodies on a number of 116 female patients with osteoporosis, who presented for lumbar pain in the endocrinology and medical rehabilitation outpatient clinic, over a period of 3 years. We observed a gradual increase in the average height only at the level of the fi rst three lumbar vertebrae, after which the average height decreased gradually at the level of the last two lumbar vertebrae. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to search for the predictive value of 3D fat analysis and calculation technique (FACT) and intravoxel incoherent motion (IVIM) parameters in identifying osteoporosis in women. Methods: We enrolled 48 female subjects who underwent 3.0 T MRI, including 3D FACT and IVIM sequences. Bone mineral density (BMD) values and Fracture Risk Assessment (FRAX) scores were obtained. Proton density fat fraction (PDFF) in the bone marrow and the real diffusion (D) value of intervertebral discs were measured on 3D FACT and IVIM images, respectively. Accuracy and bias were assessed by linear regression analysis and Bland–Altman plots. Intraclass correlation coefficients were used to assess the measurements’ reproducibility. Spearman’s rank correlation was applied to explore the correlation. MRI-based parameters were tested for significant differences among the three groups using ANOVA analyses. A receiver operating characteristic (ROC) analysis was performed. Results: The PDFF of the vertebral body showed a negative correlation with BMD (R = −0.393, p = 0.005) and a positive correlation with the FRAX score (R = 0.706, p < 0.001). The D value of intervertebral discs showed a positive correlation with BMD (R = 0.321, p = 0.024) and a negative correlation with the FRAX score (R = −0.334, p = 0.019). The area under the curve values from the ROC analysis showed that the 3D FACT and IVIM sequences could accurately differentiate between normal and osteoporosis (AUC = 0.88 using the PDFF; AUC = 0.77 using the D value). The PDFF value demonstrated a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 78.6%, 89.5%, 84.6%, and 85.0%, respectively, in its ability to predict osteoporosis. The D value had a sensitivity, specificity, PPV, and NPV of 63.16%, 92.9%, 65.0%, and 77.8%, respectively, for predicting osteoporosis. Conclusions: The 3D FACT- and IVIM-measured PDFF and D values are promising biomarkers in the assessment of bone quality and fracture risk.

Ultrasonographic assessment of the renal size can provide useful clinical information, in combination with other ultrasonographic parameters. The aims of this study were to establish the agreement between the ultrasonographic and radiographic measurements of the kidneys (K) and vertebral bodies (L5 and L6), to establish an ultrasonographic measurement of kidney-to-vertebral body (L5 and L6) ratio to estimate the renal size in cats, and to assess the impact of age, body weight, sex, and gonadal status on the ultrasonographic measurements of the kidneys, vertebral bodies, and ratios. The vertebral bodies of L5 and L6 were chosen as they were easy to identify with ultrasonography (US) using the lumbosacral junction as a landmark, and they are not usually affected by vertebral anomalies. A total of 60 cats (19 intact males, 12 neutered males, 17 intact females, and 12 neutered females) were included in the study. The cats were divided into three age groups (7 years), two body weight categories (≤ 3.5 kg and >3.5 kg), and two sex and gonadal status groups (male and female, and intact and neutered, respectively). Measurements of the renal and vertebral body length were performed on the radiographic and ultrasonographic images. Two different ratios were obtained, namely, K/L5 and K/L6. There was no significant difference between the length of both kidneys and the length of the vertebral bodies of L5 and L6 on ultrasonographic or radiographic images. There was a good agreement between ultrasonographic and radiographic measurements of both kidneys and vertebral bodies. In conclusion, the kidney length to L6 length ratio obtained was 1.81 ± 0.20 (1.76–1.86), which was useful for evaluating the size of the feline kidney and was not influenced by the age, body weight, sex, or gonadal status.

Bone cement is often used, in experimental biomechanics, as a potting agent for vertebral bodies (VB). As a consequence, it is usually included in finite element (FE) models to improve accuracy in boundary condition settings. However, bone cement material properties are typically assigned to these models based on literature data obtained from specimens created under conditions which often differ from those employed for cement end caps. These discrepancies can result in solids with different material properties from those reported. Therefore, this study aimed to analyse the effect of assigning different mechanical properties to bone cement in FE vertebral models. A porcine C2 vertebral body was potted in bone cement end caps, μ CT scanned, and tested in compression. DIC was performed on the anterior surface of the specimen to monitor the displacement. Specimen stiffness was calculated from the load-displacement output of the materials testing machine and from the machine load output and average displacement measured by DIC. Fifteen bone cement cylinders with dimensions similar to the cement end caps were produced and subjected to the same compression protocol as the vertebral specimen and average stiffness and Young moduli were estimated. Two geometrically identical vertebral body FE models were created from the μ CT images, the only difference residing in the values assigned to bone cement material properties: in one model these were obtained from the literature and in the other from the cylindrical cement samples previously tested. The average Youngs modulus of the bone cement cylindrical specimens was 1177 ± 3 MPa, considerably lower than the values reported in the literature. With this value, the FE model predicted a vertebral specimen stiffness 3% lower than that measured experimentally, while when using the value most commonly reported in similar studies, specimen stiffness was overestimated by 150%. [ABSTRACT FROM AUTHOR]

The aim of the study was to study the morphological and structural changes of the vertebral bodies in patients with different bone mineral density by MRI. Materials and methods. 81 patients with different bone mineral density (BMD) of the vertebral bodies of the lumbar spine (LS) had taken part in the study. Osteopenia was diagnosed in 33 patients, 28 have osteoporosis and 20 patients without evidence of osteoporosis (according to the DXA, which was made all the investigated) were in the control group. 69 of them were women and 12 men with a mean age 49,6 ± 7,6 years (control group), 56,5 ± 9,8 years (patients with osteopenia), 66,0 ± 9,4 years (with osteoporosis). All patients underwent dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). DXA has been made on the unit «Lunar PRODIGY Primo DHA» (analysis version: 11.40) manufacture GE Healthcare, according to the standard protocol with the definition of osteoporosis by WHO (1994). In this case, average bone mineral density BMD (g/cm2) in the bodies of L1-L4 were: in healthy ones -1,232 ± 0,06; when osteopenia - 1,032 ± 0,07; osteoporosis - 0,757 ± 0,08. The average T -test was consistent, respectively: T - 1,27 ± 0,71; T - 1,40 ± 011 , T - 3,09 ± 1,73. The difference in BMD between I and II groups was 16,2 % , between I and III groups - 25%. MRI morphometry in patients with osteopenia changes of the vertebral bodies were accompanied by POP: marked reduction in the average height of the vertebral bodies, more pronounced than in osteoporosis, a slight drop height of the front body, reducing of the Barnett-Nordin index (B/N) - 0,84. Osteopenia significantly correlated with BMD of vertebral body height rear L1, the index of B/N in the body of L4. In osteoporosis MRI morphometry data were characterized by the fact that the front and the average height of the vertebral bodies were not changed significantly. In patients with osteoporosis BMD was significantly correlated with rear height of the vertebral bodies - L1 (r - 0,49, p = 0,02), L2 (r - 0,46, p = 0,04), L3 (r - 0,45 p = 0,04). B/N index in the bodies of L1, L2 and L3 had weak connection correlation (respectively, r + 0,31 *, r + 0,25 *, r - 0,27 *). It was found that Veins Brescia visualization with MRI along with morphological changes are indicators of the bone mineral density disturbance. Results. 81 patients with different bone mineral density (BMD) of the vertebral bodies of the lumbar spine (LS) had taken part in the study. Osteopenia was diagnosed in 33 patients, 28 have osteoporosis and 20 patients without evidence of osteoporosis (according to the DXA, which was made all the investigated) were in the control group. 69 of them were women and 12 men with a mean age 49,6 ± 7,6 years (control group), 56,5 ± 9,8 years (patients with osteopenia), 66,0 ± 9,4 years (with osteoporosis). All patients underwent dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). DXA has been made on the unit «Lunar PRODIGY Primo DHA» (analysis version: 11.40) manufacture GE Healthcare, according to the standard protocol with the definition of osteoporosis by WHO (1994). In this case, average bone mineral density BMD (g/cm2) in the bodies of L1-L4 were: in healthy ones -1,232 ± 0,06; when osteopenia - 1,032 ± 0,07; osteoporosis - 0,757 ± 0,08. The average T -test was consistent, respectively: T - 1,27 ± 0,71; T - 1,40 ± 011 , T - 3,09 ± 1,73. The difference in BMD between I and II groups was 16,2 % , between I and III groups - 25%. MRI morphometry in patients with osteopenia changes of the vertebral bodies were accompanied by POP: marked reduction in the average height of the vertebral bodies, more pronounced than in osteoporosis, a slight drop height of the front body, reducing of the Barnett-Nordin index (B/N) - 0,84. Osteopenia significantly correlated with BMD of vertebral body height rear L1, the index of B/N in the body of L4. In osteoporosis MRI morphometry data were characterized by the fact that the front and the average height of the vertebral bodies were not changed significantly. In patients with osteoporosis BMD was significantly correlated with rear height of the vertebral bodies - L1 (r - 0,49, p = 0,02), L2 (r - 0,46, p = 0,04), L3 (r - 0,45 p = 0,04). B/N index in the bodies of L1, L2 and L3 had weak connection correlation (respectively, r + 0,31 *, r + 0,25 *, r - 0,27 *). Conclusion It was found that Veins Brescia visualization with MRI along with morphological changes are indicators of the bone mineral density disturbance.

Therapeutic allogeneic mesenchymal stromal cells (MSCs) are currently in clinical trials to evaluate their effectiveness in treating many different disease indications. Eventual commercialization for broad distribution will require further improvements in manufacturing processes to economically manufacture MSCs at scales sufficient to satisfy projected demands. A key contributor to the present high cost of goods sold for MSC manufacturing is the need to create master cell banks from multiple donors, which leads to variability in large-scale manufacturing runs. Therefore, the availability of large single donor depots of primary MSCs would greatly benefit the cell therapy market by reducing costs associated with manufacturing. We have discovered that an abundant population of cells possessing all the hallmarks of MSCs is tightly associated with the vertebral body (VB) bone matrix and only liberated by proteolytic digestion. Here we demonstrate that these vertebral bone-adherent (vBA) MSCs possess all the International Society of Cell and Gene Therapy-defined characteristics (e.g., plastic adherence, surface marker expression and trilineage differentiation) of MSCs, and we have therefore termed them vBA-MSCs to distinguish this population from loosely associated MSCs recovered through aspiration or rinsing of the bone marrow compartment. Pilot banking and expansion were performed with vBA-MSCs obtained from 3 deceased donors, and it was demonstrated that bank sizes averaging 2.9 × 108 ± 1.35 × 108 vBA-MSCs at passage 1 were obtainable from only 5 g of digested VB bone fragments. Each bank of cells demonstrated robust proliferation through a total of 9 passages, without significant reduction in population doubling times. The theoretical total cell yield from the entire amount of bone fragments (approximately 300 g) from each donor with limited expansion through 4 passages is 100 trillion (1 × 1014) vBA-MSCs, equating to over 105 doses at 10 × 106 cells/kg for an average 70-kg recipient. Thus, we have established a novel and plentiful source of MSCs that will benefit the cell therapy market by overcoming manufacturing and regulatory inefficiencies due to donor-to-donor variability. [ABSTRACT FROM AUTHOR]

• 1st use of Taguchi method for examining key factors in spine modelling. • Factors examined: element size, number of material properties & calibration factor. • Taguchi analysis showed that the three factors are independent. • Calibration factor is the main contributor, accounts for 97% of predicted stiffness. Finite element (FE) modelling of a vertebral body (VB) is considered challenging due to the many parameters involved such as element size and type, and material properties. Previous studies have reported how these parameters affect the mechanical behaviour of a VB model; however, most studies just compared results without any specific statistical tool to quantify their influence. The Taguchi Method (TM) has been successfully used in manufacturing and biomechanics to evaluate process parameters and to determine optimum set-up conditions. This study aimed to evaluate the influence of the main finite element modelling parameters on the mechanical behaviour of a VB model using the Taguchi Method. A FE model was developed based on a C2 juvenile porcine vertebral body and three of the most commonly used modelling parameters were evaluated using TM in terms of the change in the predicted stiffness in comparison to experimental values: element size, number of different material properties for VB (based on grey-scale bins) and calibration factor for grey-scale to density to Young's Modulus equation. The influence of the combined factors was also assessed. The Taguchi analysis showed that the three factors are independent. The calibration factor is the main contributor, accounting for 97% of the predicted stiffness, with the value of 0.03 most closely aligning the numerical and experimental results. Element size accounted for 2% of the predicted stiffness, with 0.75 mm being the optimal, while the number of grey-scale bins influenced the results by less than 1%. Our findings indicate that the calibration factor is the main modelling parameter, with the element size and number of bins accounting for less than 3% of the predicted stiffness. Therefore, calibration of material properties should be done based on a large number of samples to ensure reliable results. [ABSTRACT FROM AUTHOR]

Fat-water magnetic resonance (MR) images allow automated noninvasive analysis of morphological properties and fat fractions of vertebral bodies (VBs) and intervertebral discs (IVDs) that constitute an important part of human biomechanical systems. In this paper, we propose a fully automated approach for simultaneously segmenting multiple VBs and IVDs on fat-water MR images without prior localization or geometry estimation. This method involved a hierarchical random forest (HRF) classifier and a hierarchical conditional random field (HCRF) that encoded a multi-resolution image pyramid based on a set of multiscale local and contextual features. The HRF classifier employed penalized multivariate linear discriminants and SMOTEBagging to handle limited and imbalanced training data with large feature dimension. The HCRF estimated optimum labels according to their spatial and hierarchical consistencies by using the layer-wise significant features determined over the trained HRF classifier. To handle variable sample numbers at different resolutions, resolution-specific hyperparameters were used. This method was trained and evaluated for segmenting 15 thoracic and lumbar VBs and their IVDs on fat-water MR images of a subset of a large cohort data set. It was further evaluated for segmenting seven IVDs of the lower spine on fat-water images of a public grand challenge. These evaluations revealed the comparable accuracy of this method with the state-of-the-art while requiring less computational burden due to a simultaneous localization and segmentation. [ABSTRACT FROM AUTHOR]

Research Objective: improvement of transpedicular fixation technique in cases with spine injuries accompanied by vertebral body splintering. Material and Methods. Transpedicular spondylosynthesis was performed in 52 patients aged 18-49 years with comminuted fractures of thoracic and lumbar vertebral bodies. Individual peculiarities of the operation depended on the character of the injury ascertained during the preoperative examination. Standard roentgenography and computer tomography were used. Results. Lasting antalgic effect was observed in 94,2% of the operated patients. In cases with type A3 fractures according to F. Magerl the rate of the surgical correction of the pathologic posttraumatic kyphotic deformity averages 87%. Injuries classified as type A2, B2 or C2 were the indication for transpedicular os-teosynthesis by advanced techniques. Conclusion. Transpedicular spondylosynthesis is one of the effective methods of treatment of patients with comminuted fractures of thoracic and lumbar vertebral bodies, and the choice of carrying out of the procedure depends on the injury character. In cases with comminuted fractures of type A2, B2, C2 it is reasonable to perform transpedicular spondylosynthesis with introduction of the transpedicular screws into the injured vertebral body, and the technique of their use depends on the injury character.

Objectives: To establish a cut-off value for signal intensity ratio (SIR) in dual-phase chemical shift MRI and also to evaluate the sensitivity and specificity of this method in order to differentiate benign from malignant focal vertebral lesions. Methods: Totally 51 patients (28 men and 23 women) with a mean (=SD) age of 52.61-13.52 years (range, 27 - 81 years) with 116 vertebral focal lesions were studied. MR imagining was performed using a 1.5-Tesla superconducting system. Chemical shift sequences for sagittal in-phase (IP) were obtained at RT/ET 100 - 165/4.2 and out-phase (OP) 100 - 165/2.4. All images were sent to a picture archiving and communication system (PACS) work station and areas with abnormal SI on the T1 and T2 sequences were identified on the IP/OP. An elliptical cursor to define region of interest was used to describe the area with abnormality on the IP and OP images. We calculated the signal intensity ratio or SIR (SI of OP/SI of IP) to compare the OP with the IP images. Air was selected as the reference contrast as not influenced by fatty infiltration. Results: SIR of 0.73 (OP images compared with IP images) can be used as the best cut-off value to identify benign (SIR < 0.73) vs. malignant (SIR< 0.73) lesions with 100% sensitivity and 89.7% specificity. Conclusions: SIR values from out-phase and in-phase images (chemical shift MR imaging) may be useful for quantitatively differentiating benign from malignant focal vertebral lesions with high specificity and sensitivity. SIR values in neoplastic focal lesions were greater than benign lesion and a value of 0.73 can be used as a cut off to differentiate between benign and malignant focal lesions. [ABSTRACT FROM AUTHOR]

Diffusion-weighted MRI (DWI) of the vertebral bone marrow is a clinically important tool for the characterization of bone-marrow pathologies and, in particular, for the differentiation of benign (osteoporotic) and malignant vertebral compression fractures. DWI of the vertebral bone marrow is, however, complicated by some unique MR and tissue properties of vertebral bone marrow. Due to both the spongy microstructure of the trabecular bone and the proximity of the lungs, soft tissue, or large vessels, substantial magnetic susceptibility variations occur, which severely reduce the magnetic field homogeneity as well as the transverse relaxation time T*2, and thus complicate MRI in particular with echoplanar imaging (EPI) techniques. Therefore, alternative diffusion-weighting pulse sequence types such as single-shot fast-spin-echo sequences or segmented EPI techniques became important alternatives for quantitative DWI of the vertebral bone marrow. This review first describes pulse sequence types that are particularly important for DWI of the vertebral bone marrow. Then, data from 24 studies that made diffusion measurements of normal vertebral bone marrow are reviewed; summarizing all results, the apparent diffusion coefficient (ADC) of normal vertebral bone marrow is typically found to be between 0.2 and 0.6 × 10−3 mm2/s. Finally, DWI of vertebral compression fractures is discussed. Numerous studies demonstrate significantly greater ADCs in osteoporotic fractures (typically between 1.2 and 2.0 × 10−3 mm2/s) than in malignant fractures or lesions (typically 0.7-1.3 × 10−3 mm2/s). Alternatively, several studies used the (qualitative) image contrast of diffusion-weighted acquisitions for differentiation of lesion etiology: a very good lesion differentiation can be achieved, particularly with diffusion-weighted steady-state free precession sequences, which depict malignant lesions as hyperintense relative to normal-appearing vertebral bone marrow, in contrast to hypointense or isointense osteoporotic lesions. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Computer aided image analysis was applied to elaborate an automatic method of histomorphometric analysis of trabecular bone samples. Transverse sections of decalcified vertebral bodies were examined using optical microscopy and digital image acquisition system. Further analysis was done by means of a general purpose image analysis package. The same algorithm was applied to all the images tested, thus enabling obtainment of objective and repeatable results. High efficiency in measurements and evaluation of parameters not accessible for manual methods makes this method an interesting alternative for classical histomorphometric analysis. The results obtained demonstrated that assessment of bone mineral density is not sufficient for evaluation of compression strength of vertebral bodies. In contrast, mechanical properties correlate well with histomorphometric parameters. As a consequence it was postulated that compression strength of vertebral bodies is controlled by trabecular structure rather than bone mineral density.

Background: Unstable fractures of the spine should be managed surgically. An anterior approach allows for precise decompression of the vertebral canal and reconstruction of the fractured vertebral body. The aim of the study was to evaluate the functional and surgical outcomes of anterior surgical approaches for vertebral body removal and prosthetic reconstruction., Material and Methods: The objectives of this paper were accomplished by reviewing the course of treatment and treatment outcomes of patients operated on at the Orthopaedic Oncology Department in Brzozw and the Department of Orthopaedics and Traumatology in District Hospital in Stalowa Wola in the years 2020-2021. In total, the treatment of 54 patients was analyzed. The study only included patients with traumatic and pathological fractures who underwent a single-level corpectomy. A total of 18 patients with fractures of the cervical spine, 15 of the thoracic spine and 21 of lumbar spine were treated. Before and after treatment, patients&apos; neurological status was assessed according to the Frankel classification, performance was assessed with the Karnofsky score and pain intensity was analyzed with a VAS. The vertebral wedge angle (alpha), the ratio of the anterior height of the fractured vertebral body to the anterior height of the upper adjacent vertebral body (a/c), the ratio of the anterior height to the posterior height of the fractured vertebra (a/b) and the distance between the vertebral endplates adjacent to the fractured vertebra, measured between their anterior edges (A-B) were assessed. The most common general medical and surgical complications were also evaluated., Results: After the surgery, significant pain relief measured using a VAS was noted (the median was 7 preoperatively and 4 postoperatively) and an improvement in performance according to the Karnofsky score was observed (the median was 50 preoperatively and 70 postoperatively). Out of the 14 patients with neurologic deficits 11 improved, while 5 regained the ability to walk. In four patients, the implant migrated into an adjacent vertebra and three patients suffered a fracture of the upper adjacent vertebra. The correction of the spine deteriorated in all 7 patients. There was no postoperative neurological deterioration of patients and no infectious complications. During the surgery, three patients suffered dura mater injury, which was identified intraoperatively and repaired., Conclusions: 1. Corpectomy followed by vertebral body replacement is an effective and safe method that enables the restoration of the shape of the vertebra, restoration of the physciological spinal curvature and direct neural decompression. 2. The treatment outcomes are good. Pain significantly decreases and performance improves in most patients. 3. Treatment complications are rare. The most often observed complication was migration of the implant into an adjacent vertebral endplate, fractures above the place of fixation and dura mater injury.

This paper presents the results of a macroscopic analysis of early-stage tuberculosis in the medieval population of Devín- Castle (11th-12th century AD) and it summarizes the first data on possible occurrence of tuberculosis in a historical population from the territory of Slovakia. A total of 210 individuals (129 adults and 81 subadults) was analysed for the presence of lesions attributable to tuberculosis. First this skeletal collection was analysed only macroscopically, where special attention was given to the presence of lesions typical for a tuberculosis infection with it´s typical predilection sites (tubercle formation, ankylosis of the spine, or severe inflammation of hip joints). After typical cases of a tuberculosis infection were excluded, the study was aimed on finding early stage TB (tuberculosis) or atypical lesions possibly linked with TB (most of them referred to as "MOLAT"). Based on our findings, we assume that in this population were 6 adult individuals suffering from early stage TB (4 females and 2 males) and an unexpectedly high number of subadult individuals with lesions attributable to an early skeletal form of TB. As many as 23 out of 81 (28.40%) individuals younger than 18 years at death had skeletal changes like hypervascularisation of vertebral bodies (with or without resorptive lesions) and periosteal depositions on the ventral rib surface. As these alterations are not always tuberculosis specific and the here presented results are derived from a macroscopic observation only, they can only indicate an infectious disease, but the presence of a mycobacterial infection and its pathogen (Mycobacterium tuberculosis) causing TB can only be confirmed by a DNA analysis. Therefore the here presented data will be verified molecularly and by shot gun sequencing in a later stage of the research. [ABSTRACT FROM AUTHOR]

In clinical routine, spine pathologies can be most often deduced from the vertebral body shape, position and orientation. Additionally, per-vertebra spatial information could be used in intervention planning and surgical navigation. Especially in vertebral metastasis treatment, MRI is inalienable, and therefore, segmentation methods are developed for spine MRI. Our approach starts with a simple user-assisted initialization Then intensity and edge features are combined for a subsequent hybrid level-set segmentation. We evaluated our method on highly anisotropic clinical routine spine MRI datasets, containing 34 vertebrae, both healthy and pathological. We achieved a 3D Dice coefficient of 84.8% and a mean surface-to-surface distance of 1.29 ± 0.42 mm with regard to a manually created ground truth segmentation. The main advantages of our method are precise segmentation results on clinical routine images within reasonable processing time and with minimal user interaction. [ABSTRACT FROM AUTHOR]

Endplate morphology is understood to play an important role in the mechanical behavior of vertebral bone as well as degenerative processes in spinal tissues; however, the utility of clinical imaging modalities in assessment of the vertebral endplate has been limited. The objective of this study was to evaluate the ability of two clinical imaging modalities (digital tomosynthesis, DTS; high resolution computed tomography, HRCT) to assess endplate topography by correlating the measurements to a microcomputed tomography (μCT) standard. DTS, HRCT, and μCT images of 117 cadaveric thoracolumbar vertebrae (T10–L1; 23 male, 19 female; ages 36–100 years) were segmented, and inferior and superior endplate surface topographical distribution parameters were calculated. Both DTS and HRCT showed statistically significant correlations with μCT approaching a moderate level of correlation at the superior endplate for all measured parameters (R 2 Adj = 0.19–0.57), including averages, variability, and higher order statistical moments. Correlation of average depths at the inferior endplate was comparable to the superior case for both DTS and HRCT (R 2 Adj = 0.14–0.51), while correlations became weak or nonsignificant for higher moments of the topography distribution. DTS was able to capture variations in the endplate topography to a slightly better extent than HRCT, and taken together with the higher speed and lower radiation cost of DTS than HRCT, DTS appears preferable for endplate measurements. [ABSTRACT FROM AUTHOR]

Objectives To investigate the effect of osteoporosis and intervertebral disc degeneration on the endplate cartilage injury in rats. Methods A total of 48 female Sprague Dawley rats (3 months) were randomly divided into Groups A, B, C and D with 12 rats in each group. Osteoporosis and intervertebral disc degeneration composite model, simple degeneration model and simple osteoporosis model were prepared in Groups A, B and C respectively. After modeling, four rats of each group at 12th, 18th and 24th week were sacrificed. Intervertebral height of cervical vertebra C6/C7 was measured. Micro-CT was used to image the endplate of cephalic and caudal cartilage at C6/C7 intervertebral disc. Abraded area rate of C6 caudal and C7 cephalic cartilage endplate was calculated, and then C6/C7 intervertebral disc was routinely embedded and sectioned, stained with safranin O to observe histological changes microscopically. Results At 12, 18 and 24 weeks, intervertebral disc height of C6/C7 were (0.58±0.09) mm, (0.53±0.04) mm and (0.04±0.06) mm in Group A rats, (0.55±0.05) mm, (0.52±0.07) mm and (0.07±0.05) mm in Group B rats. At 24th week, intervertebral disc height of Group A rats was significantly lower than that of Group B rats ( P <0.05); intervertebral disc height of Groups A and B rats at each time point were significantly lower than that of Groups C and D ( P <0.05). There was no significantly statistical difference of intervertebral disc height between Groups C and D ( P >0.05). At 12 and 18 weeks, the abraded rate of C6 caudal and C7 cephalic cartilage endplate in Group A rats were significantly higher than that in Groups B, C and D rats ( P <0.05); the abraded rate in Group B was significantly higher than that in Groups C and D ( P >0.05). Microscopic observation of CT showed that ventral defects in C6 caudal or C7 cephalic cartilage endplate in Groups A and B appeared after 12 weeks of modeling; obvious cracks were found in front of the C6 and C7 vertebral body, and cartilage defect shown the trend of “repairing” at 18 and 24 weeks after modeling. Conclusions Intervertebral disc degeneration and osteoporosis can cause damage to the cartilage endplate. Co-existence of these two factors can induce more serious damage to the endplate, which has possitive correlation with intervertebral disc degeneration. Osteoporosis plays a certain role in intervertebral disc degeneration process, and accelerates the degeneration of intervertebral disc in a specific time window. [ABSTRACT FROM AUTHOR]

Ultrasonographic assessment of the renal size can provide useful clinical information, in combination with other ultrasonographic parameters. The aims of this study were to establish the agreement between the ultrasonographic and radiographic measurements of the kidneys (K) and vertebral bodies (L5 and L6), to establish an ultrasonographic measurement of kidney-to-vertebral body (L5 and L6) ratio to estimate the renal size in cats, and to assess the impact of age, body weight, sex, and gonadal status on the ultrasonographic measurements of the kidneys, vertebral bodies, and ratios. The vertebral bodies of L5 and L6 were chosen as they were easy to identify with ultrasonography (US) using the lumbosacral junction as a landmark, and they are not usually affected by vertebral anomalies. A total of 60 cats (19 intact males, 12 neutered males, 17 intact females, and 12 neutered females) were included in the study. The cats were divided into three age groups (<7 months, 7 months-7 years, and >7 years), two body weight categories (≤ 3.5 kg and >3.5 kg), and two sex and gonadal status groups (male and female, and intact and neutered, respectively). Measurements of the renal and vertebral body length were performed on the radiographic and ultrasonographic images. Two different ratios were obtained, namely, K/L5 and K/L6. There was no significant difference between the length of both kidneys and the length of the vertebral bodies of L5 and L6 on ultrasonographic or radiographic images. There was a good agreement between ultrasonographic and radiographic measurements of both kidneys and vertebral bodies. In conclusion, the kidney length to L6 length ratio obtained was 1.81 ± 0.20 (1.76-1.86), which was useful for evaluating the size of the feline kidney and was not influenced by the age, body weight, sex, or gonadal status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Martinez, Soler, Laredo, Belda and Agut.)

Abstract: Stress magnitude and variability as estimated from large scale finite element (FE) analyses have been associated with compressive strength of human vertebral cancellous cores but these relationships have not been explored for whole vertebral bodies. In this study, the objectives were to investigate the relationship of FE-calculated stress distribution parameters with experimentally determined strength, stiffness, and displacement based ductility measures in human whole vertebral bodies, investigate the effect of endplate loading conditions on vertebral stiffness, strength, and ductility and test the hypothesis that endplate topography affects vertebral ductility and stress distributions. Eighteen vertebral bodies (T6-L3 levels; 4 female and 5 male cadavers, aged 40–98years) were scanned using a flat-panel CT system and followed with axial compression testing with Wood''s metal as filler material to maintain flat boundaries between load plates and specimens. FE models were constructed using reconstructed CT images and filler material was added digitally. Two different FE models with different filler material modulus simulating Wood''s metal and intervertebral disc (W-layer and D-layer models) were used. Element material modulus to cancellous bone was based on image gray value. Average, standard deviation, and coefficient of variation of von Mises stress in vertebral bone for W-layer and D-layer models and also the ratios of FE parameters from the two models (W/D) were calculated. Inferior and superior endplate surface topographical distribution parameters were calculated. Experimental stiffness, maximum load and work to fracture had the highest correlation with FE-calculated stiffness while experimental ductility measures had highest correlations with FE-calculated average von Mises stress and W-layer to D-layer stiffness ratio. Endplate topography of the vertebra was also associated with its structural ductility and the distribution parameter that best explained this association was kurtosis of inferior endplate topography. Our results indicate that endplate topography variations may provide insight into the mechanisms responsible for vertebral fractures. [Copyright &y& Elsevier]

Predicting prognosis is the key factor in selecting the proper treatment modality for patients with spinal metastases. Therefore, various assessment systems have been designed in order to provide a basis for deciding the course of treatment. Such systems have been proposed by Tokuhashi, Sioutos, Tomita, Van der Linden, and Bauer. The scores differ greatly in the kind of parameters assessed. The aim of this study was to evaluate the prognostic value of each score. Eight parameters were assessed for 69 patients (37 male, 32 female): location, general condition, number of extraspinal bone metastases, number of spinal metastases, visceral metastases, primary tumour, severity of spinal cord palsy, and pathological fracture. Scores according to Tokuhashi (original and revised), Sioutos, Tomita, Van der Linden, and Bauer were assessed as well as a modified Bauer score without scoring for pathologic fracture. Nineteen patients were still alive as of September 2006 with a minimum follow-up of 12 months. All other patients died after a mean period of 17 months after operation. The mean overall survival period was only 3 months for lung cancer, followed by prostate (7 months), kidney (23 months), breast (35 months), and multiple myeloma (51 months). At univariate survival analysis, primary tumour and visceral metastases were significant parameters, while Karnofsky score was only significant in the group including myeloma patients. In multivariate analysis of all seven parameters assessed, primary tumour and visceral metastases were the only significant parameters. Of all seven scoring systems, the original Bauer score and a Bauer score without scoring for pathologic fracture had the best association with survival ( P < 0.001). The data of the present study emphasize that the original Bauer score and a modified Bauer score without scoring for pathologic fracture seem to be practicable and highly predictive preoperative scoring systems for patients with spinal metastases. However, decision for or against surgery should never be based alone on a prognostic score but should take symptoms like pain or neurological compromise into account. [ABSTRACT FROM AUTHOR]

The aim of the work was to determine the stiffness of vertebral bodies after vertebroplasty by means of radiological examination (CT), computer-aided design (CAD) and computer-aided engineering (CAE) systems. Twenty six patients with angiomata in vertebrae have been examined. A vertebra with pathological changes has been modelled twice, i.e. before operation and after the process of vertebral body filling with cement. The processing of CT images for the purposes of generation of 3D vertebral body models using Mimics software is also shown. In the analysis, non-homogeneous material properties of bone in the analysed areas are taken into consideration. Some problems related to the determination of non-homogeneous areas of particular material properties are discussed. FEM analyses described in the paper yielded the distributions of the stresses, strains and displacements in vertebral bodies. The stiffnesses of healthy vertebral bodies, bodies with pathological changes and bodies with bone cement injected were compared. The usefulness of the results obtained from the analyses of vertebral body stiffness for medical application in vertebroplasty was emphasised. The method presented above allows us to put forward a different approach to the problem consisting in individual examination of each patient and planning the surgery according to the case by case conditions. The computer-aided approach, using CT/CAD/CAE system, proposed above allows both improving the surgery performance and post-operative control of the patient condition. [ABSTRACT FROM AUTHOR]

Abstract: Objective. – This study will investigate interrelationships between the cortical shell and cancellous bone trabecular thickness, in vertebral bodies. Methods. – One hundred and sixty vertebral bodies from T12 to L5 were obtained at autopsy. The average age of the cohort was 59.3±22.1 years (range=20–94 years). Cortical thickness, cortical porosity and trabecular thickness from the adjacent cancellous bone were measured. Results. – At the mid-vertebral body anterior cortical thickness was significantly greater than posterior cortical thickness (524±352 vs. 370±283 μm, respectively, P <0.0001) and mid-anterior cortical porosity was significantly less than mid-posterior cortical porosity (24±14% vs. 32±16%, respectively, P <0.0001). There were no anterior/posterior differences in trabecular thickness of the cancellous bone adjacent to the cortical walls. Conclusion. – This study provides a novel perspective of T12 to L5 vertebral body bone, where measurement of cortical thickness and cortical porosity in a cohort of skeletally normal individuals revealed structural differences between load bearing anterior and posterior cortical walls. The data suggest that modulators of change to vertebral body bone may affect the cortical and trabecular bone differently. The relationships between cortical and cancellous bone suggest that the middle sectors of the vertebral body play a critical role in load bearing. [Copyright &y& Elsevier]

Résumé: Objectif. – L''objectif de cette étude est d''examiner les relations entre l''épaisseur de l''os cortical et celle de l''os spongieux des corps vertébraux. Méthodes. – Cent soixante corps vertébraux de T12 à L5 ont été obtenus par autopsie. La moyenne d''âge de la cohorte était de 59,3±22,1 ans (20–94 ans). L''épaisseur corticale, la porosité corticale et l''épaisseur trabéculaire de l''os spongieux adjacent ont été mesurées. Résultats. – L''épaisseur de la corticale antérieure de la partie médiane du corps vertébral était significativement plus importante que l''épaisseur de la corticale postérieure (respectivement 524 μm±352 μm vs 370 μm±283 μm, p <0,0001). La porosité corticale médiane antérieure était significativement plus faible que la porosité corticale médiane postérieure (respectivement 24±14 % vs 32±16 %, p <0,0001). Aucune différence antéropostérieure d''épaisseur trabéculaire n''était notée au niveau de l''os spongieux directement adjacent à l''os cortical. Conclusion. – Cette étude offre de nouvelles perspectives pour la connaissance de l''os des corps vertébraux de T12 à L5, la mesure de l''épaisseur et de la porosité corticales, au sein d''une cohorte d''individus sains au plan osseux, ayant permis de montrer des différences de structure entre les zones portantes des murs vertébraux antérieurs et postérieurs. Ces données suggèrent que les modulateurs osseux agissent différemment au niveau l''os trabéculaire et de l''os cortical. Les rapports entre l''os cortical et l''os spongieux suggèrent que la partie médiane des corps vertébraux joue un rôle décisif dans la résistance aux charges. [Copyright &y& Elsevier]